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替莫唑胺联合或不联合尼莫妥珠单抗放化疗治疗新诊断的 EGFR 阳性胶质母细胞瘤的回顾性队列研究。

Radiotherapy Plus Temozolomide With or Without Nimotuzumab Against the Newly Diagnosed EGFR-Positive Glioblastoma: A Retrospective Cohort Study.

机构信息

Department of Oncology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.

Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.

出版信息

Oncologist. 2023 Jan 18;28(1):e45-e53. doi: 10.1093/oncolo/oyac202.

Abstract

BACKGROUND

Glioblastoma (GBM) has a poor prognosis, and patients with epidermal growth factor receptor (EGFR) amplification have an even worse prognosis. Nimotuzumab is an EGFR monoclonal antibody thought to play a significant role in the treatment of GBM. This paper presents a retrospective cohort study that evaluates the clinical efficacy and safety of nimotuzumab in GBM.

MATERIALS AND METHODS

A total of 56 newly diagnosed patients with EGFR-positive GBM were included in our study. The patients were divided into radiotherapy (RT) + temozolomide (TMZ) + nimotuzumab (39 patients) and RT + TMZ (17 patients) groups based on whether or not nimotuzumab was added during RT. Progression-free survival (PFS), overall survival (OS), and toxicities were assessed.

RESULTS

The median follow-up time was 27.9 months (95% confidence interval [CI], 25.1-30.8). The median PFS was 12.4 months (95% CI, 7.8-17.0) and 8.2 months (95% CI, 6.1-10.3) in the 2 groups, respectively, P = .052. The median OS was 27.3 months (95% CI, 19.0-35.6) and 16.7 months (95% CI, 11.1-22.2), respectively, P = .018. In patients with unmethylated O6-methylguanine-DNA methyltransferase (MGMT) promoter, the PFS and OS were significantly better in patients treated with nimotuzumab than in those without nimotuzumab (median PFS: 19.3 vs 6.7 months, P = .001; median OS: 20.2 vs 13.8 months, P = .026). During the treatment period, no statistically significant difference in toxicity was noted between the 2 groups.

CONCLUSION

Our retrospective cohort study suggests the efficacy of Nimotuzumab combined with concurrent RT with TMZ in patients with newly diagnosed EGFR-positive GBM, and specifically those with unmethylated MGMT promoter. Further prospective studies are warranted to validate our findings. Besides, nimotuzumab demonstrated good safety and tolerability.

摘要

背景

胶质母细胞瘤(GBM)预后较差,表皮生长因子受体(EGFR)扩增的患者预后更差。尼莫单抗是一种 EGFR 单克隆抗体,被认为在 GBM 的治疗中发挥重要作用。本文报告了一项回顾性队列研究,评估尼莫单抗在 GBM 中的临床疗效和安全性。

材料和方法

本研究共纳入 56 例新诊断的 EGFR 阳性 GBM 患者。根据是否在放疗期间添加尼莫单抗,将患者分为放疗(RT)+替莫唑胺(TMZ)+尼莫单抗(39 例)和 RT+TMZ(17 例)组。评估无进展生存期(PFS)、总生存期(OS)和毒性。

结果

中位随访时间为 27.9 个月(95%置信区间[CI],25.1-30.8)。两组的中位 PFS 分别为 12.4 个月(95%CI,7.8-17.0)和 8.2 个月(95%CI,6.1-10.3),P=0.052。两组的中位 OS 分别为 27.3 个月(95%CI,19.0-35.6)和 16.7 个月(95%CI,11.1-22.2),P=0.018。在未甲基化 O6-甲基鸟嘌呤-DNA 甲基转移酶(MGMT)启动子的患者中,尼莫单抗治疗的患者 PFS 和 OS 明显优于未使用尼莫单抗的患者(中位 PFS:19.3 与 6.7 个月,P=0.001;中位 OS:20.2 与 13.8 个月,P=0.026)。在治疗期间,两组的毒性无统计学差异。

结论

本回顾性队列研究提示尼莫单抗联合替莫唑胺同步放疗对新诊断的 EGFR 阳性 GBM 患者,特别是未甲基化 MGMT 启动子患者有效。需要进一步的前瞻性研究来验证我们的发现。此外,尼莫单抗表现出良好的安全性和耐受性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b405/9847561/5c82c2f091e3/oyac202f0001.jpg

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